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Pharmacology > *Respiratory drugs > Flashcards

*Respiratory drugs Flashcards

1
Q

Basics of respiratory diseases

A
  • Asthma is a chronic disease characterized by hyper-responsive
    airways
  • COPD includes emphysema and chronic bronchitis and is
    currently the 4th most common cause of preventable deaths in
    the US
  • Allergic rhinitis, characterized by itchy, watery eyes, runny nose,
    and a nonproductive cough, is an extremely common condition
  • Accumulation of mucus is common in COPD and CF
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2
Q

RESPIRATORY THERAPY DRUG CLASSES

A
  • Leukotriene Inhibitors
  • Beta-2 Agonists
  • Muscarinic Receptor Antagonists
  • Steroidal Anti-Inflammatories
  • Mucolytics/Expectorants
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3
Q

Examples of leukotrine inhibitors

A
  • Montelukast
  • Zafirlukast
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4
Q

Indications of Montelukast

A
  • Asthma maintenance
  • Bronchospasm, exercise induced
  • Allergic rhinitis:
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5
Q

Mechanism of actoin of montelukast

A
  • Selectively binds to airway cysteinyl leukotriene receptors
    blocking their stimulation by their endogenous ligands (LTC4,
    LTD4, LTE4) which are released by mast cells and eosinophils
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6
Q

Adverse reactions of montelukast

A

Adverse Reactions

  • Common:
    • headache, flu-like symptoms, pruritus, rash, restlessness
  • Serious:
    • hematology: thrombocytopenia
    • Hypersensitivity: erythema nodosum, angioedema

Topical Ophthalmic Drug Interactions

  • None

Contraindications/Cautions

  • No applicable ophthalmic conditions or findings
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7
Q

Asthma therapy

A
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8
Q

BETA-2 AGONISTS used in the treatment of asthma

A
  • Short-Acting
    • 7 Albuterol aka Salbutamol
    • Levalbuterol aka Levosalbutamol
    • Metaproterenol
  • Long-Acting
    • Formoterol
    • Salmeterol
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9
Q

Indications of Albuterol(Salbutamol)(B2 agonist)

A
  • Bronchospasm
  • Acute bronchospasm
  • Exercise-induced bronchospasm
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10
Q

Mechanism of action of Albuterol(Salbutamol)

A
  • Selectively stimulates β2 adrenergic receptors causing
    relaxation in airway smooth muscle
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11
Q

Adverse reactions of Albuterol(Salbutamol) (B2 agonist)

A

Adverse Reactions

  • Common:
    • cough,
    • dizziness,
    • headache
  • Severe:
    • Respiratory: paradoxical bronchospasm
    • CVS: hypertension, angina, MI, arrhythmias

Topical Ophthalmic Drug Interactions

  • None

Cautions

  • Hypertension
  • Diabetes mellitus
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12
Q

Exxamples of MUSCARINIC RECEPTOR ANTAGONISTS

A
  • Long-Acting Muscarinic Antagonist (LAMA)
    • Tiotropium [Spiriva Handihaler®, Spiriva Respimat®]
  • Short-Acting Muscarinic Antagonist (SAMA)
    • Ipratropium [Atrovent HFA®]
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13
Q

Indications of triotropium

A
  • COPD
  • Asthma
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14
Q

Mechanism of action of triotropium

A
  • Antagonizes acetylcholine receptors producing
    bronchodilation
  • (long acting muscarinic antagonist)
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15
Q

Adverse reactions of triotropium

A
  • Common:
    • cough,
    • dizziness,
    • headache
  • Severe:
    • Ocular: Angle-closure glaucoma

Topical Ophthalmic Drug Interactions

  • None

Cautions

  • Angle-closure glaucoma
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16
Q

Indications for the use of FLUTICASONE(steroid)

A
  • Acts through classic steroid pathway inhibiting arachidonic
    acid-based eicosanoid production

Combination of fluticasone & salmeterol indicated for COPD and asthma maintenance

17
Q

Advrese reactions of fluticasone

A
  • Common:
    • headache,
    • cough,
    • pyrexia,
    • epistaxis
  • Severe:
    • Hormonal: adrenal suppression, hypercorticism,
      pediatric growth suppression
    • Nasal: nasal/oral candidiasis, nasal ulcer or septal
      perforation
    • Ocular: cataracts, glaucoma, elevated IOP
18
Q

Mechanism of action of salmeterol(long acting B2 agonist)

A
  • A chemical analog of Albuterol having a lipophilic side chain
    that enhances duration of action; like Albuterol, this β2 Agonist
    produces relaxation of airway smooth muscle
19
Q

Adverese reactions of salmeterol(B2 agonist)

A
  • Common:
    • headache
  • ​Severe:
    • Hypersensitivity: anaphylaxis, angioedema
    • Respiratory: paradoxical bronchospasm, asthma
    • CV: arrhythmia, HTN
20
Q

ADVAIR DISKUS (salmeterol/fluticasone combo) cautions for use

A
  • Hypertension
  • Diabetes mellitus
  • Active infection
  • Ocular: HSV infection, glaucoma, cataracts
21
Q

Indications for momentasone (steroid nasal spray)

A
  • Allergic Rhinitis
  • Nasal Polyp Therapy
22
Q

Mometasone mechanism of action

A
  • Steroid
  • Inhibits multiple inflammatory cytokines; produces multiple
    glucocorticoid and mineralocorticoid effects
23
Q

Adverse reactions of mometasone(steroid)

A
  • Common: Headache, viral infection, epistaxis
    • Ocular: conjunctivitis
  • Serious:
    • Sinus: Septal perforation, ulcer, candidiasis
      Ocular: Elevated IOP, glaucoma

Topical Ophthalmic Drug Interactions

  • None

Cautions

  • Ocular: HSV infection, glaucoma, cataracts
24
Q

Examples of mucolytics

(maak slym los)

A
  • Guaifenesin [Mucinex®]
  • Acetylcysteine (Acc 200)
25
Q

Indications of guaifenecin

A
  • Expectorant
26
Q

Mechanism of action of guaifenecin

A
  • Increases volume/decreases viscosity of respiratory tract
    secretion
27
Q

Indications of acetylcysteine

A
  • Mucolytic: individualized nebulizer dosing, 200 mg PO bid-tid
  • Acetaminophen Overdose (paracetamol overdose)
28
Q

Mechanism of action of acetylcysteine

A
  • Breaks disulfide bonds, decreasing mucus viscosity
  • Overdose: *Replenishes glutathione, facilitating non-toxic metabolism of
    acetaminophen
29
Q

Adverse reactions of acetylcysteine

A

Adverse Reactions

  • Common:
    • Flushing,
    • pruritus,
    • tachycardia

Topical Ophthalmic Drug Interactions

  • None

Contraindications/Cautions

  • No applicable ophthalmic conditions or findings
30
Q
A

Pharmacology (19 decks)

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